Behavioral Case Manager II Job at Elevance Health (Richmond)

New

Behavioral Health - Care Manager II - Autism

The Behavioral Health - Care Manager II - Autism is responsible for managing psy...

Location

United States of America , Virtual

Salary:

Not provided

Elevance Health

Expiration Date

March 27, 2026

Requirements

MA/MS in social work counseling or a related behavioral health field or a degree in nursing
Minimum of 3 years of experience with facility-based and/or outpatient psychiatric and substance abuse or substance abuse disorder treatment
Current active unrestricted license such as RN, LCSW, LMSW, LMHC, LPC, LBA (as allowed by applicable state laws), LMFT or Clinical Psychologist to practice as a health professional within the scope of licensure in applicable states or territory of the United States required
For states that do not require licensure a Board Certified Behavioral Analyst (BCBA) is also acceptable if all of the following criteria are met: performs UM approvals only, reviews requests for Applied Behavioral Analysis (ABA) services only, and there is licensed staff supervision
Previous experience in case management/utilization management required
Prior managed care experience required

Job Responsibility

Managing psychiatric and substance abuse or substance abuse disorder facility-based and outpatient professional treatment health benefits through telephonic or written review
Uses appropriate screening criteria knowledge and clinical judgment to assess member needs to ensure access to medically necessary quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract
Refers cases to Peer Reviewers as appropriate
Performs psychiatric and substance abuse or substance abuse disorder assessment coordination implementation case planning monitoring and evaluating to promote quality member outcomes to optimize member health benefits and to promote effective use of health benefits and community resources
Will serve as a resource to other BH Care Managers
Assists with more complex cases and may participate in inter and intradepartmental teams projects and initiatives

What we offer

Merit increases
Paid holidays
Paid Time Off
Incentive bonus programs (unless covered by a collective bargaining agreement)
Medical
Dental
Vision
Short and long term disability benefits
401(k) +match
Stock purchase plan

Fulltime

!

New

Behavioral Health - Case Manager II

The Behavioral Health - Case Manager II is responsible for performing case manag...

Location

United States of America , Boston; Woburn

Salary:

70664.00 - 110814.00 USD / Year

Elevance Health

Expiration Date

March 25, 2026

Requirements

Requires MA/MS in social work, counseling or a related behavioral health field or a degree in nursing
minimum of 3 years of clinical experience in social work, counseling with broad range of experience with complex psychiatric and substance abuse or substance abuse disorder treatment
any combination of education and experience which would provide an equivalent background
Current active unrestricted license such as RN, LCSW, LMHC, LICSW, LPC (as allowed by applicable state laws), LMFT, LMSW (as allowed by applicable state laws) or Clinical Psychologist to practice as a health professional within the scope of licensure in applicable states or territory of the United States required
Previous experience in case management and telephonic and/or in person coaching with members with a broad range of complex psychiatric/substance abuse and/or medical disorders
Managed care experience required

Job Responsibility

Responds to more complex cases and account specific requests
Uses appropriate screening criteria, knowledge and clinical judgment to assess member needs
Conducts assessments to identify individual needs and develops specific care plan to address objectives and goals as identified during assessment
Monitors and evaluates effectiveness of care plan and modifies plan as needed
Supports member access to appropriate quality and cost effective care
Coordinates with internal and external resources to meet identified needs of the members and collaborates with providers
Serves as a resource to other BH Case Mgrs
Participates in cross-functional teams, projects and initiatives

What we offer

comprehensive benefits package
incentive and recognition programs
equity stock purchase
401k contribution
merit increases
paid holidays
Paid Time Off
incentive bonus programs
medical, dental, vision, short and long term disability benefits
401(k) +match

Fulltime

!

New

Behavioral Health - Care Manager II - Autism - BCBA - LBA

The Behavioral Health - Care Manager II - Autism is responsible for managing psy...

Location

United States of America , Virtual

Salary:

Not provided

Elevance Health

Expiration Date

March 27, 2026

Requirements

MA/MS in social work counseling or a related behavioral health field or a degree in nursing
Minimum of 3 years of experience with facility-based and/or outpatient psychiatric and substance abuse or substance abuse disorder treatment
Current active unrestricted license such as RN, LCSW, LMSW, LMHC, LPC, LBA (as allowed by applicable state laws), LMFT or Clinical Psychologist to practice as a health professional within the scope of licensure in applicable states or territory of the United States required
For states that do not require licensure a Board Certified Behavioral Analyst (BCBA) is also acceptable if all of the following criteria are met: performs UM approvals only, reviews requests for Applied Behavioral Analysis (ABA) services only, and there is licensed staff supervision
Previous experience in case management/utilization management required
Prior managed care experience required

Job Responsibility

Manage psychiatric and substance abuse or substance abuse disorder facility-based and outpatient professional treatment health benefits through telephonic or written review
Use appropriate screening criteria knowledge and clinical judgment to assess member needs to ensure access to medically necessary quality behavioral healthcare in a cost effective setting in accordance with UM Clinical Guidelines and contract
Refer cases to Peer Reviewers as appropriate
Perform psychiatric and substance abuse or substance abuse disorder assessment coordination implementation case planning monitoring and evaluating to promote quality member outcomes to optimize member health benefits and to promote effective use of health benefits and community resources
Serve as a resource to other BH Care Managers
Assist with more complex cases and may participate in inter and intradepartmental teams projects and initiatives

What we offer

Merit increases
Paid holidays
Paid Time Off
Incentive bonus programs (unless covered by a collective bargaining agreement)
Medical
Dental
Vision
Short and long term disability benefits
401(k) +match
Stock purchase plan

Fulltime

!

Sr. Underwriter - Life Insurance

Location

United States , Sioux Falls

Salary:

69523.00 - 115871.00 USD / Year

Sammons Financial Group

Expiration Date

Until further notice

Requirements

Bachelor's Degree or equivalent industry related experience Required
4-6 years of life insurance underwriting with above average performance or approval authority of $2M or above Required
Specialized knowledge and experience in life underwriting and risk selection with proven decision-making ability Required
Knowledge of medical and non-medical risk factors and the ability to apply these factors in reaching the most favorable underwriting decision Required
Excellent decision making skills with the ability to solve problems innovatively to find ‘win-win’ solutions
Strong verbal and written communication skills
Self-starter with excellent teamwork skills
ability to work independently to accomplish work goals and a willingness to sacrifice personal goals to help achiever overall team success
Superior ability to listen and be responsive to customers and who can sell difficult decisions while showing empathy
Desire and ability to effectively work with diverse personalities

Job Responsibility

Evaluate applications for life insurance to classify risks by using company risk selection standards while promoting additional sales of quality business
Obtain the information necessary, based on the circumstances of each case, to evaluate each proposed insured’s qualification for the plan and amount of life insurance applied for
Call the Agent on every case where an adverse underwriting decision is involved to explain the reason and discuss alternatives, including the use of facultative reinsurance
Help Regional Sales Directors and MGAs build their business by leading customized Game Plans and attracting new producers
Initiate communication with agents and providers to facilitate the application and policy issue process
use the most effective means of communication available - telephone, facsimile, electronic mail, etc
Direct Case Managers in obtaining required information and in providing information to agents, other employees and service providers
Provide guidance to the Case Manager in screening applications for Jet Issue
Take final action on cases as authorized by the Manager, Underwriting pertaining to case size and mortality class
refer cases outside authorized limits to underwriting personnel with the requisite authority

What we offer

Health, Dental, Vision, Company Paid Retirement, PTO and Holiday Pay
Employee Stock Ownership Plan (ESOP) is a 100% company-funded retirement plan
Healthy balance between work and personal lives
Friday afternoons off all year long, competitive PTO, and generous number of paid holidays
Incentive program for defined goals subject to eligibility and performance
Colleagues who support one another, model our core values, and drive our healthy, high-performing culture

Fulltime

Care Management Specialist II, D-SNP Team

The Care Management Specialist II utilizes clinical skills and training to perfo...

Location

United States , Los Angeles

Salary:

88854.00 - 142166.00 USD / Year

L.A. Care Health Plan

Expiration Date

Until further notice

Requirements

Associate's Degree in Nursing for Registered Nurses OR Master's Degree in Social Work for Licensed Clinical Social Workers
Minimum of 3 years of recent care management experience with responsibilities of managing complex acute or chronic conditions in collaboration with members and interdisciplinary care professionals in a hospital, medical group or managed care setting, such as a health insurance environment and/or experience as care manager in home health or hospice environments
Experience providing care management with complex/catastrophic conditions
Current knowledge of clinical standards of care and disease processes
Critical thinking skill
Excellent customer service skills
Ability to clinically analyze the most complex cases involving highly acute physical health, behavioral health, complex/catastrophic and/or psychosocial issues to determine and implement the most effective member-centered interventions
Ability to triage immediate member health and safety risks
Ability to sensitively manage member or family responses associated with high acuity cases and support effective coping
Strong verbal and written communications skills to consult effectively with interdisciplinary teams, coordinate care with members and their families, and other internal and external stakeholders

Job Responsibility

Utilizes clinical skills and training to perform essential functions of care management for identified and assigned member population according to Health Insurance Portability and Accountability Act (HIPAA) guidelines
Manages a specified caseload across the entire continuum of programmatic levels including those within National Committee for Quality Assurance (NCQA) scope or otherwise Complex/Catastrophic cases
Management of the caseload assigned by Manager includes: coordinating health care benefits, providing education and facilitating member access to care in a timely and cost-effective manner
Collaborates and communicates with member, family, and interdisciplinary health team to promote wellness and member empowerment, while ensuring access to appropriate services across the healthcare continuum and maximizing member benefit
Serves as clinical advocate for members, active interdisciplinary team member, liaison with other departments and external health care team
Provides direction and assistance to Care Coordinators and to Community Health Workers (CHW) of members needs including the need for special educational mailings, reminder calls, satisfaction surveys, incentives or any additional service needs according to specific program guidelines
Uses claims processing and care management software to look up member information, document contacts, and track member progress
Applies clinical knowledge and experience to evaluate information regarding prospective care management members referred by health risk assessment (HRA), risk stratification, predictive modeling, provider’s utilization review vendors, members, Call Center, claims staff, Health Homes Program (HHP) eligibility or other data sources to determine whether care management intervention is necessary to meet the member's needs
Conducts Care Management services for the most complex and vulnerable members including: engaging in member centric communication which includes the interdisciplinary team, providers and family or authorized representatives
reviewing member claims histories and identifies intervention opportunities through the professional standards of practice

What we offer

Paid Time Off (PTO)
Tuition Reimbursement
Retirement Plans
Medical, Dental and Vision
Wellness Program
Volunteer Time Off (VTO)

Fulltime

Store Retail Loss Prevention Customer Service Associate II

Supports the District Loss Prevention Manager and Store Management by executing ...

Location

United States , Barboursville

Salary:

13.30 - 18.60 USD / Hour

TK Maxx

Expiration Date

Until further notice

Requirements

Strong verbal and written communication
Sound decision making skills
Ability to take initiative and perform well independently
Prioritizes/organizes workload and manages time effectively
Able to stand for long periods of time
0-2 years retail or security experience

Job Responsibility

Maintains a proper and professional stance in the designated area at the front of the store
Act as a visual deterrent to prevent potential loss/dishonesty
Review and understand the Store Emergency Response Guide
Wear a complete Company approved uniform including a Body Worn Camera
Greet customers appropriately, demonstrate courtesy and respect
Establish and maintain a position at the front of the store or in a department
Respond to customer requests for assistance by referring customers to store management or customer service via a Company issued radio
Observe and report any suspicious behavior or critical incidents to LP or store management
Perform a closing safety sweep of the store with a member of management
Adhere to all Company Policy and Procedure

What we offer

Associate discount
EAP
smoking cessation
bereavement
401(k) Associate contributions
child care & cell phone discounts
pet & legal insurance
credit union
referral bonuses
401(k) match

Fulltime

Product System Architect

Location

India , Bangalore

Salary:

Not provided

Aptiv plc

Expiration Date

Until further notice

Requirements

Lead the design and development of product system architectures
Define the overall structure, components, interfaces, and behaviors of complex automotive systems
Analyze the capabilities and limitations of product systems
Gather, analyze, and prioritize stakeholder requirements
Develop and document system requirements using standardized formats and tools such as DOORS
Define and manage the interfaces between system components, subsystems, and external entities
Utilize MBSE methodologies and tools such as SysML to model, simulate, and analyze system architectures
Conduct risk assessments
Develop validation and verification plans
Define test cases, procedures, and acceptance criteria

Fulltime

Technical Support Engineer II - Applications

The GoFundMe Pro team is searching for our next Technical Support Engineer 2 - A...

Location

Argentina , Buenos Aires

Salary:

Not provided

GoFundMe

Expiration Date

Until further notice

Requirements

2+ years of experience in technical support engineering
Proven experience with SaaS application integrations
Expertise in CRM platforms, such as Salesforce
Excellent oral and written communication skills. Thoughtful and knowledgeable
Ability to listen, educate, and empower others
A process-oriented approach to tasks with the ability to be resourceful when a process doesn’t exist or the answer is unknown
Demonstrated ability to own and drive performance metrics
Adaptability and empathy to deliver top-notch experiences to our clients
A passion for driving community engagement
Enthusiasm for innovation, change, and thinking big

Job Responsibility

Customer experience ownership: Manage and own a customer or persona’s experience across the platform as it relates to unexpected behavior
Work with cross functional partners to triage and prioritize defects across the experience
Collaborate internally and cross functionally
Attend some scrum meetings
Support account management teams on calls as necessary
Create and maintain internal documentation related to relevant product subject matter and wider technical processes
Showcase technical communication skills
Manage escalated cases and queue health
Deeper troubleshooting of cases TSE L1 was unable to resolve
Coach TSE L1 on resolution

What we offer

Make an Impact: Be part of a mission-driven organization
Innovative Environment: Work with a diverse, passionate, and talented team
Collaborative Team: Join a fun and collaborative team
Competitive Benefits: Enjoy competitive pay and comprehensive healthcare benefits
Holistic Support: Enjoy financial assistance for things like hybrid work, family planning, along with generous parental leave, flexible time-off policies, and mental health and wellness resources
Growth Opportunities: Participate in learning, development, and recognition programs
Commitment to DEI: Contribute to diversity, equity, and inclusion through ongoing initiatives and employee resource groups
Community Engagement: Make a difference through our volunteering program

Behavioral Case Manager II

Elevance Health

Location:
United States , Richmond ▼
Norfolk
Chesapeake
Hampton
Leesburg
Smithfield
Suffolk
Virginia Beach
Williamsburg

Category:
Health and Beauty

Contract Type:
Not provided

Salary:

Job Description:

Job Responsibility:

Requirements:

Nice to have:

Additional Information:

Job Posted:
March 21, 2026

Expiration:
April 11, 2026

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